Effective with date of service Aug. 1, 2025, NC Medicaid covers benzathine benzylpenicillin (Extencilline®) and benzathine benzylpenicillin tetrahydrate (Lentocilin).
Topics Related to Medicaid Managed Care
NC Medicaid is implementing changes to the Nursing Facility process to support providers and members.
The revised NC Medicaid 1915(i) Assessment includes new date fields and must be used starting Oct. 1, 2025.
Announcing Coverage-67516 Suprachoroidal Space Injection of Pharmacologic Agent (separate procedure)
Current Procedural Terminology code 67516 has replaced category III code 0465T.
Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.
Standard Plans will reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
The strategy outlines visions and goals for NC Medicaid Managed Care for the next three years.
NC Medicaid has released a new online tool for beneficiaries to compare the five available Standard Plans. The 2025 NC Medicaid Standard Plan Performance Comparison Tool is now available online.
Providers can continue billing Diagnosis Related Group claims using revenue code 0161 for room and board and occurrence span code 82.
Temporary flexibilities to the Innovations Waiver after Hurricane Helene are ending July 1, 2025.